Individual provider Active NPI

Kenneth Yuen-Jing Lo

  • Physical Therapist
  • Dublin, CA
National Provider Identifier
1396382602
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25223 Issued in CA
Practice address
5073 Piper Glen Ter
Dublin, CA 94568-7490
Phone
(650) 218-2542
NPI assigned
Dec 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 25223 CA Primary

Addresses

Primary practice location

5073 Piper Glen Ter
Dublin, CA 94568-7490

Mailing address

5073 Piper Glen Ter
Dublin, CA 94568-7490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25223CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1396382602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5073 PIPER GLEN TER",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945687490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5073 PIPER GLEN TER",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945687490",
            "telephone_number": "650-218-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "KENNETH",
        "middle_name": "YUEN-JING",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "25223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.